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AFFIDAVIT OF DISCREPANCY - For Sss

This affidavit describes a discrepancy in the spelling of the affiant's late husband's family name. The affidavit states that the husband's family name was misspelled on the marriage contract as "________" instead of the correct spelling of "________". The affiant executes this affidavit to attest to the truth of the discrepancy and to use it for an SSS burial and death claim for her late husband.

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Betty Camp
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3K views1 page

AFFIDAVIT OF DISCREPANCY - For Sss

This affidavit describes a discrepancy in the spelling of the affiant's late husband's family name. The affidavit states that the husband's family name was misspelled on the marriage contract as "________" instead of the correct spelling of "________". The affiant executes this affidavit to attest to the truth of the discrepancy and to use it for an SSS burial and death claim for her late husband.

Uploaded by

Betty Camp
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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AFFIDAVIT OF DISCREPANCY

I, ______, of legal age, widow, and with address at ____________,


under oath, state:

1. THAT I was married with my late husband, ________, on


February 19, 1970, solemnized by Municipal Judge,
____________ at the office of the Municipal Judge of La Paz,
Agusan del Sur;

2. THAT the family name of my late husband and his father


was inadvertently misspelled as “_________” as stated and
registered in our Marriage Contract issued by office of the
Civil Registry of the municipality of La Paz, Agusan del
Sur, instead of “__________” which is his true and correct
family name. A copy of my Marriage Contract is hereto
attached as ANNEX “A”;

3. THAT I am executing this Affidavit to attest to the truth of


the foregoing facts and to use the same for the SSS burial
and death claim of my late husband, _______________.

IN WITNESS WHEREOF, I hereunto affix my signature this 24 th


day of November, 2020 at Butuan City.

__________________
Affiant

SUBSCRIBED AND SWORN to before me this 24th day of


November, 2020 at Butuan City, Affiant exhibiting to me her
COMELEC ID with VIN: 0304-0043A-K2449MBG20000 issued at La
Paz, Agusan del Sur.

 
Doc No. ________;
Page No. _______ ;
Book No. _______;
Series of ________.
 

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